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2024

In-Office Procedures and the ‘Scope’ of Practice for APPs

In-Office Procedures and the ‘Scope’ of Practice for APPs

Posted by | Jun 2024

Terran W. Sims, NP, MSN, ACNP-C, CNN, COCN-C, discusses how to prepare and incorporate advanced practice providers (APPs) like nurse practitioners and physician assistants in urologic procedures. Ms. Sims begins by listing office procedures APPs might encounter, focusing on cystoscopy, stent removal, and difficult catheter insertion. She continues by posing a guiding question for her discussion: what is the best fit for APPs in practice?

Ms. Sims then briefly reviews differences in the scope of practice for APPs across the U.S., noting important state licensure requirements and highlighting the increasing presence of APP participation in urologic procedures. She emphasizes the American Urological Association’s (AUA) and Society of Urologic Nurses and Associates’ (SUNA) support for APP involvement, and utilizes cystoscopy as an example by detailing data that show increased levels of patient satisfaction as APPs have performed greater numbers of cystoscopy procedures.

Ms. Sims concludes by addressing the primary obstacles to additional APP role expansion: the lack of training and lack of standard curriculum. She encourages urologists to overcome these obstacles and invest in APPs by providing training, instilling confidence, and maintaining mentorship. She reiterates the benefits of APP involvement, including increased cost-effectiveness, profit margins, and team productivity.

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Radiation Therapy Planning Using Advanced Imaging – Pearls and Pitfalls

Radiation Therapy Planning Using Advanced Imaging – Pearls and Pitfalls

Posted by | Jun 2024

Dr. Sean P. Collins discusses radiation therapy planning for prostate cancer, emphasizing the role of advanced imaging technologies. He underscores how these technologies enhance the precision of targeting cancerous tissues while minimizing radiation exposure to surrounding healthy tissues.
Dr. Collins elaborates on various advanced imaging modalities, including multiparametric MRI and PET/CT scans. He believes that integrating these imaging techniques into the radiation therapy planning process can result in more precise dose distributions, leading to better tumor control and fewer adverse effects.
Despite the clear advantages, Dr. Collins also addresses the potential pitfalls associated with advanced imaging in radiation therapy planning. Variability in image quality, the potential for imaging artifacts, and the necessity for specialized expertise in interpreting complex imaging data are addressed, as well as ways to mitigate these challenges.

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Rise of the Machines: AI in Prostate MRI

Rise of the Machines: AI in Prostate MRI

Posted by | Jun 2024

Baris Turkbey, MD, explores the capabilities and training gaps of Artificial Intelligence in MRI prostate cancer detection. He begins by establishing the ubiquity of MRI technology in prostate cancer treatment across the globe and highlighting the shortcomings of previous and current guidelines on the use of MRI for disease detection.

Dr. Turkbey highlights the shortcomings of previous and current guidelines on the use of MRI for disease detection, noting that current data is too dependent on the experience of the practitioner. He then introduces the idea of using Artificial Intelligence (AI) to standardize prostate cancer detection.

Dr. Turkbey then presents examples of AI successfully detecting prostate cancer lesions on MRI imaging. However, he cautions that more rigorous training and supervision is still needed for AI imaging, as AI has a high false-positive rate.

Dr. Turkbey concludes by examining the impact of image quality on AI performance, indicating that more training is required before these models can be deployed as a diagnostic aid. He presents data that demonstrates that low-quality images significantly impact the cancer detection rate of AI models.

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Focal Therapy for Prostate Cancer: Role of Brachytherapy

Focal Therapy for Prostate Cancer: Role of Brachytherapy

Posted by | Jun 2024

Dr. Daniel Y. Song examines the critical role of brachytherapy as a focal therapy in the management of prostate cancer, emphasizing its significance within the broader context of precision oncology. Dr. Song discusses the technical aspects and advancements in brachytherapy, including the use of image-guided techniques. He underscores the importance of meticulous planning and execution in achieving optimal therapeutic outcomes.
Dr. Song also addresses the evolving role of brachytherapy in the era of multimodal treatment approaches. He explores its integration with other therapeutic modalities, such as external beam radiation therapy and hormonal therapy, to enhance treatment efficacy and tailor interventions to individual patient profiles. This approach aligns with the principles of personalized medicine, aiming to optimize therapeutic benefits while minimizing treatment-related morbidity.

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